Myofascial Disorder

Chiropractic Nimmo Receptor-Tonus Technique and McKenzie Self-Therapy Program in the Management of Adjacent Segment Disease: A Case Report

By Frank M. Painter|January 17, 2022|Adjacent Segment Disease, Case Studies, McKenzie, Myofascial Disorder, Myofascial Trigger Points|

Chiropractic Nimmo Receptor-Tonus Technique and McKenzie Self-Therapy Program in the Management of Adjacent Segment Disease: A Case Report

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2020 (Dec); 19 (4): 249–259

Emsal Salik, MD PhD; Ali Donat, DC; Mustafa Hulisi Ağaoğlu, DC

Chiropractic Program,
Health Sciences Institute,
Bahcesehir University,
Besiktas, Istanbul, Turkey

Objective: The objective of the present study objective was to describe adjacent segment disease (ASD) from a chiropractic management prospective and subsequently to stimulate further research into the chiropractic therapeutic effects on such cases and to contribute to chiropractic literature.

Clinical features: A 44–year-old woman had a history of lumbar stabilization revision operation by pedicle screw fixation for spondylolisthesis. Her intractable back pain episodes, which were diagnosed as ASD, began shortly after this surgery. At presentation, she was taking pregabalin 75 mg 2 times a day for postoperative neuropathic pain without any pain relief. Clinical testing revealed myofascial tender points reproducing the pain.

Intervention and outcome: After taking the case history and performing a physical examination, the patient was managed with chiropractic Nimmo receptor-tonus technique in combination with McKenzie exercises. Nimmo was applied by manually pressing on clinically relevant points for 5 to 15 seconds in 11 visits over 3 weeks. The patient by herself did McKenzie exercises 5 to 10 times a day for 10 to 12 repetitions over 2 months. After 3 weeks of therapy, visual analog scale and Oswestry Disability Index scores were improved. Furthermore, because of the amelioration of the patient’s symptoms, her neurosurgeon successfully discontinued pregabalin 75 mg 2 times a day without negative consequences to care.

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Referred Pain from Myofascial Trigger Points in Head and Neck

By Frank M. Painter|October 21, 2018|Headache, Myofascial Disorder, Pediatrics|

Referred Pain from Myofascial Trigger Points in Head and Neck-shoulder Muscles Reproduces Head Pain Features in Children With Chronic Tension type Headache

The Chiro.Org Blog

SOURCE: J Headache Pain. 2011 (Feb); 12 (1): 35–43

César Fernández-de-las-Peñas, Daniel M. Fernández-Mayoralas, Ricardo Ortega-Santiago, Silvia Ambite-Quesada, Domingo Palacios-Ceña and Juan A. Pareja

Department of Physical Therapy,
Occupational Therapy,
Rehabilitation and Physical Medicine,
Facultad de Ciencias de la Salud,
Universidad Rey Juan Carlos,
Avenida de Atenas s/n,
28922 Alcorcón, Madrid

Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children’s condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured.

The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

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Immediate Effects of Spinal Manipulative Therapy on Regional Antinociceptive Effects in Myofascial Tissues in Healthy Young Adults

By Frank M. Painter|November 14, 2015|Chiropractic Care, Myofascial Disorder|

Immediate Effects of Spinal Manipulative Therapy on Regional Antinociceptive Effects in Myofascial Tissues in Healthy Young Adults

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2013 (Jul); 36 (6): 333–341 ~ FULL TEXT

John Z. Srbely, DC PhD, Howard Vernon, DC, PhD,
David Lee, DC, Miranda Polgar, BSc

Department of Human Health and Nutritional Science,
University of Guelph, Guelph,
Ontario, Canada

OBJECTIVE: The purpose of this study was to investigate if spinal manipulative therapy (SMT) can evoke immediate regional antinociceptive effects in myofascial tissues by increasing pressure pain thresholds (PPTs) over myofascial trigger points in healthy young adults.

METHODS: A total of 36 participants (19 men, 17 women; age, 28.0 [5.3] years; body mass index, 26.5 [5.7] kg/m(2)) with clinically identifiable myofascial trigger points in the infraspinatus and gluteus medius muscles were recruited from the University of Guelph, Ontario, Canada. Participants were randomly allocated to 2 groups. Participants in the test group received chiropractic SMT targeted to the C5-C6 spinal segment. Participants in the control group received sham SMT. The PPT was recorded from the right infraspinatus and gluteus medius muscles at baseline (preintervention) and 1, 5, 10, and 15 minutes postintervention.

RESULTS: Three participants were disqualified, resulting in a total of 33 participants analyzed. Significant increases in the pressure pain thresholds (PPT) [decreased pain sensitivity] were observed in the test infraspinatus group when compared with test gluteus medius, control infraspinatus, and control gluteus medius groups (P < .05). No significant differences in PPT were observed at any time point when comparing test gluteus medius, control infraspinatus, and control gluteus medius groups (P > .05).

CONCLUSIONS: This study showed that SMT evokes short-term regional increases in PPT within myofascial tissues in healthy young adults.

Key Indexing Terms: Manipulation, Myofascial Pain Syndrome, Myofascial Trigger Point, Pain Threshold, Chiropractic

From the Full-Text Article:

Introduction

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Conservative Chiropractic Management of Urinary Incontinence Using Applied Kinesiology: A Retrospective Case-series Report

By Frank M. Painter|September 12, 2012|Myofascial Disorder, Myofascial Trigger Points, Spinal Manipulation, Urinary Incontinence|

Conservative Chiropractic Management of Urinary Incontinence Using Applied Kinesiology: A Retrospective Case-series Report

The Chiro.Org Blog

SOURCE: J Chiropr Med. 2012 (Mar); 11 (1): 49–57 ~ FULL TEXT

Scott C. Cuthbert and Anthony L. Rosner

Chief Clinician, Chiropractic Health Center, PC, Pueblo, CO 81004

OBJECTIVE: The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI).

CLINICAL FEATURES: Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI.

INTERVENTION AND OUTCOME: Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable.

CONCLUSION: The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time.

From the Full-Text Article:

Introduction

Urinary incontinence (UI) occurs when there is leakage of urine involuntarily, most commonly in older patients. [1] Fantl et al [2] state that incontinence affects 4 of 10 women and 1 of 10 men during their lifetime, and about 17% of children younger than 15 years. A large postpartum study of the prevalence of UI found that 45% of women experienced UI at 7 years postpartum. Thirty-one percent who were initially continent in the postpartum period became incontinent in the future. [3] (more…)

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